Posttraumatic
stress disorder (PTSD) is
often called an “injury” because it actually causes dysfunction in parts of the
brain that control memory (the hippocampus) and fear (the amygdala).This causes
them to operate at cross-purposes,
leading to a host of often disabling symptoms.

Nonetheless,
PTSD is a hidden injury because it
leaves no visible scars, such as those left by a gun or knife attack.There
are no broken limbs from PTSD alone and
the victim is not confined to a wheelchair.They walk, they talk and often act in ways that seem “normal enough”
yet, inside, they are a cauldron of disturbing thoughts, emotions and
anxieties.

Where does
PTSD even come from?As the name implies, of course, it comes from
that thing called trauma.To understand
this, however, one must recognize some simple definitions.First, “stress”
and “trauma” are two entirely
different things—yet we tend to use them interchangeably as though they mean
the same thing.Stress alone does not
cause PTSD—stress is a routine, daily part of life. It can even help you get
that promotion you’ve been seeking, finish a marathon, or plan a vacation.It’s
“a state of mental or emotional strain
or tension resulting from adverse or very demanding circumstances,” and can
result in an abundance of stomach problems, headaches and ulcers. Over fifty
percent of doctor’s visits are from stress related conditions and ailments.

“Trauma”
is entirely different. Put simply, trauma is “the result of a
perceived threat that exceeds one's ability to cope.”It goes far beyond
mere stress alone.The person senses a life-threatening danger
physically or emotionally from an event or events.There is a sense of helplessness
that goes
with it, far exceeding that experienced from mere stress.This is where PTSD
comes from.

It’s
important to remember that there
are two types of trauma that result in PTSD, however—critical incident trauma
(such as a gunfight or violent child
death) and cumulative trauma (a
series of events, such as accumulated screams, fights, or repeated exposure to
disastrous scenes).

We’re
all familiar with the trauma that
results from a critical incident—it can be compared to a Mack truck running
over you on the highway.It’s a
“headliner,” in which everyone in the office—and even the public—knows you’ve
been involved in something traumatic.Help is, in many cases, immediate.

Cumulative
trauma is more insidious,
however.A good comparison is a
bumblebee sting.One is irritating, two
or three are more painful, and too many stings require medical attention.Cumulative
trauma may show itself at any
stage of a career and can build over the years, sometimes manifesting it just
before—or after—retirement.It can be
just as destructive to the psyche as critical incident trauma.Help is usually
delayed or non-existent
because the onset is unseen.

How do you
know if you’re suffering from
one of these injuries?There are a few
characteristics that are common to both.

Insomnia

Nightmares
and night terrors

Uncharacteristic
anger and displays of
temper

Substance
abuse

Flashbacks

Depression

Anxiety

Scattered
thinking

Suicidal thoughts

For law enforcement,
there are two keys
to avoiding the impacts of critical and cumulative trauma: prevention and
treatment.“Prevention” means doing
something proactively for yourself.One
must first recognize that police work is one of the most toxic, caustic career
fields in the world.It is rife with
potential trauma.One must—and can—head
off the trauma before it impacts you permanently.This is why we at Badge of Life recommend a voluntary,
annual “mental health check-in” with a licensed therapist of your choice. You
do this with the same diligence as seeing your doctor once a year for a
physical exam or your dentist for a cleaning and dental check.

To do this,
you may want to choose your
department’s psychologist, if there is one, or partake of the services of your
employee assistance program.Some
officers are suspicious of these avenues, however, and if you fit that category
we recommend you go “outside” a select a therapist on your own or as
recommended by others.Here, with a
small co-pay, your confidentiality is absolute (unless you’re a danger to
yourself of others).

Having a checkup
like this is for
“healthy” officers as well as those experiencing problems—it’s an opportunity
to look at the past year, see what has worked well and examine what
hasn’t.It’s a chance to identify any
trauma that has occurred or is in the process of catching up with you.It’s
an occasion to do something good for
yourself and counter the unhealthy things you’re running into on the streets.

If you need
help—if the anxiety,
sleeplessness or other symptoms are catching up with you, don’t delay.This
is where “treatment” comes into it.Get help for yourself as soon
as
possible.Doing so can save your career.Getting help can mean seeing that licensed
therapist and, if they so recommend, getting the services of a good
psychiatrist for medications.PTSD and
depression go hand-in-hand, and a simple anti-depressant combined with therapy
can make the difference between a long, healthy career versus a disability
retirement or discharge.

If you find
yourself in immediate
danger, such as contemplating suicide, call the National Suicide Prevention Lifeline.They’re staffed by compassionate professionals
who are local to you, will listen, and can direct you to appropriate
assistance.

You owe these
things to yourself.Fifteen to eighteen percent of police
officers in the United States are estimated to suffer the symptoms of
PTSD.You needn’t be one of them, but if
you are, there are some things you can do about it.

Andy
O’Hara is the founder and a board member of the Badge of Life organization. Andy has
co-authored one book and has written numerous articles for publication. He is
an advanced peer support officer, working with individuals to find appropriate
help and ways to deal with law enforcement issues. Andy is a 24-year veteran of
the California Highway Patrol, was suicidal and retired with PTSD.